Abstract
Background/Objectives: Inflammatory Bowel Disease (IBD) often occurs during early adulthood and substantially affects physical, psychological, and relational well-being. Although sexual health is a fundamental component of quality of life, it is rarely addressed in clinical practice and remains insufficiently explored in research. This study aimed to explore the lived experiences of individuals with IBD regarding sexuality and intimate relationships. Methods: Qualitative phenomenological design was adopted. Nineteen adults with a confirmed diagnosis of Crohn's disease or Ulcerative Colitis were purposively recruited from a gastroenterology and endoscopy unit of a university hospital in Southern Italy. Data were collected through in-depth, audio-recorded interviews conducted in Italian, transcribed verbatim, and analyzed using Cohen's phenomenological method. Lincoln and Guba's criteria were applied to ensure methodological rigor. Results: Five main themes and two subthemes emerged. Participants reported that IBD profoundly affected their sexual lives, not only through physical symptoms but also by eliciting emotional distress and avoidance behaviors. Stigmatization of symptoms such as incontinence and bloating frequently led to withdrawal from physical intimacy. Changes in body image, including weight fluctuations, scarring, and fear of a possible stoma, were associated with feelings of shame and self-alienation. Sexuality was often described as mechanical and emotionally detached, although some participants reported processes of relational reconnection. Concerns about relationship stability and uncertainty about the future were common, alongside a persistent lack of communication with healthcare professionals regarding sexual health. Conclusions: Sexual health in people with IBD is essential yet frequently overlooked. A holistic and empathetic approach that integrates sexual health into routine IBD care may enhance emotional well-being, improve partner communication, and strengthen the overall quality of care.